CHELAN ASHLEY MALMBERG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

CHELAN

Middle

ASHLEY

Last Name

MALMBERG

Suffix

Business Name

CHELAN ASHLEY MALMBERG MD

Original Issue Date

07/28/2009

Effective Date

04/12/2011

Expiration Date

07/31/2014

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014